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December 2008 Edition

Panels Discuss Climate Change, Primary Care

Haitian women wade through floodwaters from Hurricane Ike. Extreme weather events are among the most serious climate-related health threats facing the Americas. Photo courtesy Ministry of Health of Haiti.

The impact of climate change on health and the renewal of primary health care were the topics of two roundtables held as part of the 48th Pan American Health Organization (PAHO) Directing Council meeting in September/October.

Human-influenced climate change is having detectable impacts on public health, said participants in the roundtable "Climate Change and Its Impact on Public Health: A Regional Perspective." Changes in precipitation patterns are affecting the availability of fresh water and food as well as the range and incidence of diseases including malnutrition, diarrhea, and malaria. To face these risks, participants said, countries should prepare their health systems by strengthening core public health interventions, paying greater attention to environmental and socioeconomic determinants of health, and focusing on the management of environmental risks and emergencies, particularly natural disasters.

Equally important is a "rethinking of the models of development in our countries and thinking what it means to construct sustainable societies," said María Fernanda Espinosa, Ecuador's ambassador to the United Nations.

In the panel on primary health care, Wim Van Lerbeghe, of the World Health Organization's (WHO) Health Systems and Services Cluster, noted that WHO's 2008 World Health Report (here) calls for a renewal of primary health care to meet changing health needs and growing demands for greater equity in health. People around the world are demanding a stronger voice in health care, Van Lerbeghe said, and have higher expectations for levels and quality of care. Their expectations are not being met by current health systems. He said major progress is needed toward universal access to care to meet these expectations, and that restructuring health systems around the principles of primary health care offers the best solution to this challenge.

Michael Marmot, chairman of the WHO Commission on the Social Determinants of Health, called for putting "fairness" back onto the health and development agendas, with an emphasis on social justice, empowering people and communities, and creating conditions for people to live fulfilling lives. He noted that health and socioeconomic status are strongly correlated; people with low socioeconomic status also tend to have the poorest health. And though the major causes of death and illness affect all population groups, they affect the poor and disadvantaged disproportionately. He said this calls for action across the spectrum of society, including progress toward universal access to health care.

Socorro Gross, PAHO's assistant director, noted that Latin American and Caribbean countries have increasingly turned their focus to primary health care over the past eight years as part of collective commitments to advancing such principles as equity, the right to health, universality, social justice, participation, and the responsibility of the state. She said the greatest challenge facing the region was to articulate work on improving health systems with work that addresses the determinants of health, and she noted that PAHO's core strategies all share this objective. She called for more coordinated action at the global, regional, subregional, national, subnational, and community levels, and highlighted PAHO's efforts to promote technical cooperation among and within countries.